High genotypic diversity of human papillomavirus among women in Cameroon: implications for vaccine effectiveness
Michel Carlos Tommo Tchouaket, Joseph Fokam, Samuel Martin Sosso, Ezéchiel Ngoufack Jagni Semengue, Yagaï Bouba, Rachel Kamgaing Simo, Zacharie Sando, Alex Durand Nka, Gaëlle Panka Tchinda, Désiré Takou, Nadine Fainguem, Collins Ambe Chenwi, Aude Christelle Ka’e, Aissatou Abba, Marie Krystel Nnomo Zam, Carlo-Federicco Perno, Vittorio Colizzi, Alexis Ndjolo
Abstract
ABSTRACT Background The burden of human papillomavirus (HPV) is high in Cameroon, but knowledge on high-risk oncogenic HPV (HR-HPV) is limited. Our study sought to ascertain the HR-HPV genotypes circulating in Cameroon. Methods A cross-sectional study was conducted among non-vaccinated women in Cameroon. Detection of HR-HPV was performed by real-time PCR on cervico-vaginal swabs. Predictors of HR-HPV were determined following logistic regression analysis , with p < 0.05 considered statistically significant. Results In total, 364 women were enrolled, with a median age of 41 (34–50) years. Of these, 3.0% were smokers and 26.09% reported having more than three sexual partners. The overall HR-HPV positivity rate was 21.43% (95% CI 17.21–25.64). Predictors of HR-HPV were young age, i.e < 41 years (aOR (95% CI) 0.408 (0.194–0.862); p = 0.018), smoking (aOR 5.199 (1.314–20.575); p = 0.018), and having more than three sex partners (aOR: 2.335 (1.133–4.811); p = 0.022). Overall, 12 HR-HPV genotypes were identified, with 26.98% women coinfected with at least two HR-HPVs, including one case of a triple coinfection . According to to the circulating genotypes, potential vaccine effectiveness was 47% for the 4-valent vaccine and 70% for the 9-valent vaccine. Conclusion Within the Cameroonian context, at least one out of five women is likely to be an HR-HPV carrier, especially among young people, smokers, and those with multiple sexual partners. Importantly, HR-HPV infection is highly diversified, with vaccine efficacy ranging from about 47% (4-valent) to 70% (9-valent).